P.O. Box 5675, Berkeley, CA94705USA
CARING FOR THE DISPLACED:
COMBATING SEXUAL EXPLOITATION AND HIV/AIDS AMONG REFUGEE CAMPS BY INCREASING WOMEN’S PARTICIPATION
Contact Information:
Jan Rachel Reyes, Edith Coliver Intern
Representing Human Rights Advocates through
University of San Francisco School of Law’s
International Human Rights Clinic
Tel: 415-422-6946
(Professor Connie de la Vega)
()
The HIV/AIDS epidemic continues to be a major crisis. Two-thirds (67%) of the global total of 32.9 million people living with HIV live within Sub-Saharan Africa, an area including refugee host countries such as the Democratic Republic of Congo, Liberia, Sierra Leone, Cote d’Ivoire and Sudan.[1] Adding to this medical alarm, a disturbing study commissioned in 2002 as well as further reports from Congo, Liberia, Southern Sudan, Cote d’Ivoire and Haiti[2] reveal that refugee women and children, residing in Sub-Saharan countries, are falling victim to sexual exploitation and gender-based violence. Perpetrators not only include UN peacekeepers, but staff of various notable and large humanitarian agencies – the very people entrusted with the safety and protection of refugee rights. Such vulnerability indicates that refugees, lacking the protections of their host country and the familiarity of their homeland, are particularly susceptible to HIV/AIDS. Despite numerous attempts to address these concerns by engaging more women at all decision levels, revelations indicate continued failure at effectively preventing and protecting women and children in armed conflict or post-conflict settings from sexual violence. The problem is not cured by merely equalizing the participation of men and women at all decision-making levels, but requires the increased and immediate implementation of women’s involvement in refugee care.
This paper seeks to demonstrate the inadequacy of current handling of sexual violence against refugee women and children by peacekeepers and aid workers, and the subsequent medical implications of such violations. Part I describes the reasons victims and violators continue to perpetuate the cycle of violence. Part II details the link between exploitation with the proliferation of HIV/AIDS and the inadequacies of current responses to the problem. Part III presents the UN instruments laying a foundation from which effective protection can be implemented. Part IV calls for enforcement of agreements and accountability, demanding for measures that will provide health care to refugees and deter and punish perpetrators.
- SEXUAL EXPLOITATION OF REFUGEE WOMEN AND CHILDREN
In order to end the HIV/AIDS crisis among refugee women and children, the underlying issue of sexual exploitation must be addressed. Just as HIV/AIDS continues to grow, recent statistics display a growing trend of displacement. At the end of 2007, refugee populations under The Office of the United Nations High Commissioner for Refugees (UNHCR) mandate increased to 11.4 million.[3] Women and children comprise the majority of this enormous number, and by fact of their age and gender, are undoubtedly most susceptible to exploitation by people in positions of money and power.[4] The majority of refugee children abused are girls between the ages of twelve and older, with an awareness that girls as young as eight are also involved.[5] Those girls at the highest risk tend to be under the age of fourteen; living by themselves or heading households of younger siblings; orphaned; separated from their parents; living with very old parents or with single mothers; coming from families that were very poor; or living with step parents, foster parents or extended family members.[6]
The pattern of humanitarian assistance results in overwhelming dependency and desperation among refugees for food and other-nonmonetary items or services. Such severe economic deprivation of insufficient rations and supplies force women and children to trade sex for food. Distribution of food occurs on a monthly or bimonthly basis,[7] but rations are frequently incomplete and delivery sometimes delayed.[8] When food is provided, rations are assumed to last for 30 days but in reality only last for 10.[9] This “zero week” gap from when rations run out and another distribution is often when women and girls turn to ‘transactional sex’ as a coping mechanism to make ends meet.
A patriarchal hierarchy further plagues the camp structure. Decisions about food-assistance are generally made by international organizations and host countries in consultation with the male leaders of the camps, without including the effective participation of refugee women.[10] Men predominantly control the distribution process, with women remaining mere beneficiaries.[11] When there is a surplus of items left over after distribution, men can use their discretionary power to control the ultimate distribution of excess rations. Women remain misinformed about how their entitlements and allocations are decided – ultimately leaving them powerless and distrustful of the process.[12]
Women’s lack of income-generating opportunities make it incapable of sustaining long term stability. These countries of refuge often have feeble economies unable to provide adequate funding.[13] Non-governmental organizations (NGOs) and UNHCR occasionally hire, but most jobs are in day labor where almost always only male refugees are hired.[14] Training programs for women are unsuccessful when there are no jobs available for these women to utilize their skills, or there are insufficient funds to sustain small business attempts.[15]
Because of the nature of conflict, social norms are frequently destroyed, facilitating a woman or child’s willingness or need to engage in transactional sex. Pressure from parents and other family members socializes the abuse. Refugees reported that the only way to access money in the community is to sell their food rations and let their daughters into sexually exploitative relationships.[16] Although the community does not approve of such practices, they have come to accept it because of their weak position in camp life.[17]
Nonchalance and a long history of sexual abuse by military personnel in times of war perpetuate the continuance of sexual abuse violations by UN Peacekeepers.[18] In addition, the rapid proliferation of military personnel and escalating desperation for money have led to a growing sex industry and commercial sex work.[19] While some regions have more centralized sex work in the form of brothels and discos, African peacekeeping troops live intermingled with the community.[20] This suggests increased access to refugees and, thus, increased vulnerability. Within only a few months of deployment to Sudan, members of the UN peacekeeping forces in Sudan faced allegations of raping and abusing children as young as 12.[21] Accountability to enforce appropriate conduct of UN peacekeepers and aid workers is lost between overseeing the UN forces, military leaders and officials of the countries of origin.[22] From 2004 to 2007, almost 200 UN peacekeepers were disciplined for sexual offenses, but none were prosecuted.[23] These facts depict the major problem where the remedy has been merely the return to their national authority for further punishment which most likely does not occur.
With easy access to supplies and in powerful positions, reports show that perpetrators in Liberia, Guinea and Sierra Leone, without exception, include humanitarian aid workers, generally adult men between 30 to 60 years of age.[24] In these countries alone, almost 70 aid workers from 40 agencies were implicated, including Doctors Without Borders, the International Federation of the Red Cross, UNHCR, Save the Children and UN Operation World Food Programme.[25] NGO and UN employees are seen as men of status, paid more than most other employees.[26] Rather than money, payment used to entice girls is in the form of food or material goods. Other agency workers even exchange sex for assistance with refugee status determination in the asylum country.[27]Findings also suggest it is common for international NGOs to enlist the help of local NGOs to solicit girls for sex.[28]
Inadequate mechanisms are in place for reporting abuses and to safeguard a refugee’s health and confidentiality. Refugees feel they are unable to challenge agency staff because of their dependency on goods and services.[29] First, refugees do not know where to report cases of underage sex when members of camp management and leaders are themselves involved.[30] Second, with NGO workers held in such high regard and treated as important people by the community, refugees fear retaliation or withdrawal of their provisions.[31] It is reported that, “Refugees complained that they have tried to send written complaints through other staff but that the information has been held back. Children complained that they are harassed or labeled or denied services when they tried to complain. Refugees spoke of trying to see senior staff but being stopped by security guards outside their offices.”[32] Should a refugee report or file a complaint, that refugee could potentially be singled out and prevented from receiving further aid or that the NGOs will simply pick up and move operations.[33]The further a camp is from the UNHCR branch office, the less attention the camp’s residents receive from international staff.[34]Thus, with few international staff of either UNHCR or implementing partners physically working in the camps, actual management of the camps is left to local staff and other refugees with very limited supervision.[35] Further, a ‘conspiracy of silence’ exists among the agency workers, where staff will not pass on information about a colleague involved in sexual exploitation for risk of being stigmatized and ostracized.[36]
Third, conditions in the camps help further problems where staff work under extremely difficult and minimally rewarding circumstances. Though there are members who are highly dedicated, there are others fatigued by their environment and whose commitment and interest in refugees vary.[37] Fourth, viewing transactional sex as monetarily beneficial, refugees refuse to report cases. Some refugees involved believe exchange of sex for goods as valuable and advantageous.[38]
Furthermore, in many cases, the legal framework within a country is set up in such a way as to place huge obstacles before those willing to complain. Lack of legal protection and law enforcement dissuades women and children from pursuing complaints.[39] Other reasons why refugees fail to seek redress include lack of laws against sexual and gender-based violence, application of customary and traditional laws and practices that enforce gender discrimination, lack of trust in law enforcement authorities, discriminatory practice in justice administration and law enforcement, lack of willingness to effectively prosecute all cases reported to authorities, low number of prosecutions obtained in proportion to the number of cases reported, police and courts inaccessible because of remote location of camp, absence of female law enforcement officers, lack of administrative resources and equipment by local courts and security officials, and laws or practices in the administration of justice that support gender.[40]
- HIV/AIDS AS A RESULT OF SEXUAL EXPLOITATION
Thus, with humanitarian aid workers and UN Peacekeepers committing acts of sexual violence with impunity, there is a substantial threat to the health and well-being of refugees. To illustrate this point, Dr. Pumina Mane, Director of Policy, Evidence and Partnerships at UNAIDS, stated that refugee women and girls are often disproportionately affected by displacement and thus need special attention in terms of HIV including protection form violence and exploitation.[41] Though reports of sexual exploitation of refugees emerge internationally, Africa is the only region where the principal victims are refugee women and girls.[42] In Sub-Saharan Africa, women account for 59% of adults living with HIV.[43] For example, Liberia, a country torn by civil war, faces 75-80% of its population infected with at least one STD.[44] Reports indicate that military personnel in twenty-one African countries have almost twice the chance of being HIV infected as civilian populations.[45] Higher HIV prevalence in militaries is partly the result of the concentration of high-risk age and sex groups (men aged 18-24 years; low levels of maturity, high levels of aggression, susceptibility to peer pressure, heavy substance use, long periods away from families and the reverence for risky behavior).”[46] Furthermore, nations with high or near-high AIDS prevalence contribute 37% of all UN Peacekeepers.[47]
Though there is only anecdotal evidence or biased data linking exploitation and HIV rates, it is safe to assume that where there is forced or coerced transactional sex, there is an increased risk of infection because of these high-risk behavior patterns. For example, during the UN mission in Cambodia from 1992 to 1993, the number of sex houses and “Thai-style” massage parlors multiplied and the number of prostitutes rose from 6,000 to 25,000, including an increased number of child prostitutes.[48]Cambodia’s HIV rates rose and sexually transmitted infections spread among Cambodian prostitutes.[49] Thus, those most likely to be victims of sexual exploitation are also those most likely to contract an STD.
Adolescents and girl children are in greater danger of infection than older individuals in similar circumstances.[50] First, being both biologically and socially immature, they make uninformed decisions, are forced or manipulated into sex. Refugee children are also more vulnerable due to a lesser developed reproductive tract, while malnutrition (easily caused by the exploitive distribution process) can also diminish both a child and a woman’s immune system preventing their natural physiological resistance to infection.[51] Second, children are less likely to have been reached with accurate information and consequences of HIV and the means to prevent contraction of the disease.[52] Third, even with access to this information, refugee children are unable to effectively use it due to their disempowered status and lack of skills. Fourth, due to their age, lack of power and the aforementioned reasons above, refugee children are less able to negotiate safe sexual practices including the use on contraceptives or choice of partner.[53] Finally, a fear of AIDS has actually fostered the exploitation of younger girls deemed to be virgins, assumed to be free of infection and even a tool to cleanse oneself from infection.[54]
Prevention and treatment of HIV/AIDS have met significant obstacles. Refugees often do not have access to HIV prevention commodities and programs. With the average length of stay in refugee camps before repatriation being 17 years worldwide, displacement for so long requires adequate assistance from the host country.[55] However, host countries are often already overburdened by the effect of HIV, and are often unable or unwilling to provide the HIV-related services refugees need, much less providing other basic needs such as food.[56] Thus, refugee women and children who are at high risk do not receive information or services to prevent disease and treatment.
Even when conflict subsides or ends, previously low HIV prevalence populations can move from rural to urban centers, formerly separate populations begin mixing again, and increased resources create power structures that may facilitate sexual exploitation.[57] Host communities and refugee populations remain very uneducated about HIV, so that whether groups remain separated or intermingled, knowledge has no effect on prevention on infection. Even if training is provided on both the refugee level and the protector level, the stigma associated with HIV/AIDS is so pervasive it leads to denial and silence of the epidemics and, thus, limits effectiveness of educational tools. Refugees themselves not only judge those with HIV/AIDS, they, as a group, are often falsely perceived as having higher HIV prevalence when historical evidence shows that refugees often migrate from countries with lower HIV prevalence to countries with high HIV prevalence.[58] Communities also draw upon myths about how HIV is transmitted.
Attempts at educating and training troops to the prevention and consequences of contracting HIV/AIDS also proved ineffective. Programs in effect are rarely monitored or assessed.[59] When peacekeepers arrive for their missions, they are offered induction training, consisting of only basic facts about HIV/AIDS. A survey of a few guidelines for aid workers in terms of their relationships and conduct with refugees does not indicate that these workers are being trained in terms of safe sex practices should they violate their obligations to the safety and security of refugees. Though more attention is being directed at addressing HIV/AIDS in the context of emergency settings, it is imperative that aid workers understand sexual abuse in relation to infection.
Finally, the second-class position of refugee women and children and exclusion at decision-making levels prevents HIV/AIDS from being a more significant and recognized consequence of sexual exploitation. With men holding positions of power, abuse of disempowered peoples continues unabated. If women are forced to remain silent about their abuse and silent about their medical conditions, they will not seek treatment and problems continue and spread.